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LETTER OF TRANSFER/PROMOTION
INFORMATION SHEET
_______________________________________
-------------------(TODAY'S DATE)---------------------
Employee's Name:_______________________________________________________
Address: _______________________________________________________________
City: _____________________________ State _____________ PYE ___________
Zip:_______________ Center: ___________________________________________
Program: ___________________ PA & %: _____________ KERA %______________
Job Title: (To)_________________________________________________________
(From) _______________________________________________________________
Starting Date: ______________________ Introductory Period _____________ Days
Classification:________________* (Introductory) _____________
* (regular/temporary full-time, regular/temporary part-time, introductory/full time)
BENEFITS: ____ FULL ____ NONE ____ ANNUAL LEAVE ____ SICK LEAVE
PARTIAL: (Explain Specifics Benefits): ______________________________________
______________________________________________________________________
LOCID _______________
CERS _______________
# OF WEEKS ______________
Immediate Supervisor: _______________________________________________
Job Location: ________________________________________________________
----------------------------------(Center)--------------------(County)-------------------(City)-----------
Employee's
Working Hours: From: ___________a.m./p.m. To: _____________a.m./p.m.
Total Working Hours per Week: _______________________________________________
Salary: (FROM) a.____________ b.____________ c.______________ d.____________
-------------------------------(a. Rate)-------(b. Hour/Month)-------(c. Grade)-----------(d. Step)----
Salary: (TO)___ a. ____________ b. ___________ c. _____________ d. ___________
-------------------------------(a. Rate)-------(b. Hour/Month)-------(c. Grade)-----------(d. Step)----
Signature of AACS Project Director: _______________________________________
Signature of Executive Director: ___________________________________________
Please submit this completed application information form to:
Judy Grant, Personnel and Orientation Director
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Last updated by
on April 7, 2005